Individual
DR. KENNETH J. MANGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
810 SYCAMORE ST, SUITE 100, CINCINNATI, OH 45202-2156
(513) 784-1333
(513) 338-1920
Mailing address
810 SYCAMORE ST, SUITE 100, CINCINNATI, OH 45202-2156
(513) 784-1333
(513) 338-1920
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3656
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0638859
—
OH
Enumeration date
05/18/2006
Last updated
11/16/2010
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